“We’re not pulling the rug out from under anybody,” said Tom Price, the Secretary of Health and Human Services. The goal of the House’s and the Senate’s health plans, and the Trump administration’s goal, he said, is “ensuring that there are more individuals who are insured under the new plan than under the old plan”—the old plan being the Affordable Care Act.

The nonpartisan Congressional Budget Office, however, has estimated that under the American Health Care Act introduced by the House, the number of uninsured people would increase by 23 million. (There is not an estimate for the Senate bill yet.) Price was interviewed Sunday by The Atlantic’s editor-in-chief, Jeffrey Goldberg, at the Aspen Ideas Festival, which is co-hosted by the Aspen Institute and The Atlantic. If the goal of the bills is to get health insurance to more people, and the CBO score says the House bill, at least, will not—how to explain that discrepancy? Goldberg asked. “Is the CBO wrong?”

“Yes,” Price said. “The CBO does a great job on budget; they do a relatively poor job of what the coverage consequences of a healthcare plan are. Their ability—anybody’s ability—to predict what human behavior is going to be without looking at the entire construct, is difficult. I would suggest to you that the numbers the CBO had before with the ACA, and the numbers they have now, are not accurate.”

Mick Mulvaney, the director of the White House Office of Management and budget has previously criticized the CBO’s accuracy with its original Affordable Care Act score, saying: “If the CBO was right about Obamacare to begin with, there'd be 8 million more people on Obamacare today than there actually are. So, I love the folks at the CBO, they work really hard. They do. Sometimes we ask them to do stuff that they're not capable of doing." The fact-checking organization Politifactrated this claim as “half-true.” The CBO did overestimate the number of people who would purchase their own coverage under the ACA’s exchanges. But it revised those estimates over time, and, Politifact says, “independent analyses, as well as experts agree that the CBO offers some of the best estimates given the information available at the time.”

Price listed the principles he believes should drive a healthcare system: affordability, accessibility, high quality, and the incentivization of innovation.

“My sense is that the Senate bill gets us closer to those principles compared to the current law,” he said.

And would President Trump guarantee that under this plan, no one would fall through the cracks? Goldberg asked.

“That is the goal of the plan,” Price said. But “There are no guarantees in life, Jeff, you know that.”

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